Intraocular hemorrhage from wound neovascularization years after anterior segment surgery (Swan syndrome).

At the Mayo Clinic from 1972 to 1986, 15 patients (17 eyes) had intraocular hemorrhage due to neovascularization of the stromal wound years after anterior segment surgery (Swan syndrome). Months to years after surgery patients complained of low-grade blurring that was painless and transient. The hemorrhage was seen after intracapsular cataract extraction, and one third of the patients had had an intraocular lens implant. Of the 15 patients 14 were referred, 6 for vitreous hemorrhage, 5 for recurrent hyphema, 2 for amaurosis fugax and 1 for recurrent uveitis. The average time between surgery and presentation was 4 years. The initial visual acuity was better than 20/40 in 15 eyes (extremes 20/20 and hand movement), and intraocular pressure was elevated above 30 mm Hg in 2 eyes. Treatment included periodic observation (in 10 eyes), goniophotocoagulation (in 7) and limbal cryopexy (in 3). After a mean follow-up period of 3 years all 17 eyes showed normal acuity and intraocular pressure. No patient had intractable glaucoma or phthisis.